Robert F. Kennedy, Jr. is President-elect Donald Trump’s controversial pick to lead the nation’s leading health agency, the Department of Health and Human Services, which has oversight over countless aspects of health care in the United States. A lot of what the public knows about Kennedy is based on sensational news coverage garnered from his colorful run for president last year, which featured brain worms, a dead bear in New York City’s Central Park and an uncouth last-minute allegiance with Trump that presumably landed him the HHS nomination.
Kennedy is a former environmental lawyer and a former candidate for President who is maybe best known for his controversial opinions about vaccines, which he alleges cause autism and other illnesses despite a lack of scientific evidence to prove the link. Although there is no data for Kennedy’s claims, that has not stopped Kennedy from sticking to them. While Kennedy assures his critics that he would not deny anyone a vaccine and that he believes individuals should have a choice about whether to get a vaccine, some worry that his personal beliefs about the dangers of vaccines could make it harder for vaccines to be developed or approved and could fuel public suspicion about the value of vaccines for improving public health.
Unproven connections between vaccines and their potential medical consequences are not the only provocative view that Kennedy espouses, however. He also opposes fluoride in drinking water, which many experts credit with reducing tooth decay by up to 25%.
In addition, Kennedy has some strong perspectives about the detrimental influence of prescription drug corporations. For instance, he has repeatedly called for a ban on advertising prescription drugs on television–a key tactic to drive demand for new prescription drugs. Direct marketing of prescriptions to consumers is already prohibited in most other countries. In fact, aside from the United States, there is only one other country–New Zealand–that permits advertising of prescription medicines on TV. This advertising contributes heavily to increased consumer demand for prescriptions, overmedication of the American public and inflated profits for drug corporations. Meanwhile, research shows that heavily advertised drugs have no better therapeutic impact on patients than existing treatments. The American Medical Association agrees with Kennedy’s view on drugs, calling for a ban on direct advertising over a decade ago. Executive action to stop tv ads pushing expensive prescription medicines would also garner wide support from a wide segment of the public and, most likely, from the new President himself.
In his “Make America Healthy Again” proposal, Kennedy argues that drug corporations and food suppliers are responsible for increased rates of chronic disease, including widespread obesity, and that federal agencies are complicit because of their failure to hold these corporations accountable. Kennedy has repeatedly called for action to better regulate nutrition, particularly for children and in public programs and for reducing chemical additives in the nation’s food supply. That perspective is actually popular among many experts.
Some state governments, notably California, have already taken action to address this link by regulating consumption of “junk” foods and ultraprocessed food products especially by children. Last week, for instance, CA Governor Newsom, issued an executive order requiring the state department of public health to provide recommendations about how to further limit health harms caused by ultraprocessed foods. Newsom’s order notes that the United States permits more than 10,000 chemical additives like dyes and preservatives in food, far surpassing other countries. The current executive action builds on past legislation that made California the first state in the nation to prohibit four additives (brominated vegetable oil, potassium bromate, propylparaben and red dye No. 3) found in popular cereal, soda, candy and drinks.
It’s unclear how much of the American food supply is ultraprocessed, though some recent studies it could be well beyond 50%. Health and Human Services oversees about 77% of the U.S. food supply and regulates the safety of nearly $4 trillion worth of food, tobacco and medical products, according to federal data. If Kennedy is successfully confirmed by the Senate and takes the helm, implementing some of his proposals to crack down on chemicals in food and limiting the influence of Big Pharma and other corporate stakeholders could be a top priority under his leadership.
Kennedy has a wide variety of views that provoke support and opposition from a diverse range of stakeholders on both sides of the political divide. President-elect Trump, who has championed him for HHS Secretary, for instance, is a fan of fast food restaurants like McDonalds, that Kennedy persistently criticizes. Trump also opposes Kennedy’s views on the health impacts of climate change, particularly the role of Big Oil in polluting air, water and food. Many other conservative lawmakers oppose Kennedy’s support for abortion access.
The degree to which Kennedy may act on his positions should he be confirmed will depend on a number of factors, not the least of which is the President himself. Trump must sign off on any major policy initiatives, regulatory changes or executive orders that could advance Kennedy’s views. In many ways, Kennedy is a stark contrast to Trump’s previous HHS Director, former Eli Lily CEO Alex Azar, who was a champion for the pharmaceutical industry. It remains an open question whether the federal government’s relationship with corporate stakeholders will change meaningfully under a Kennedy-led HHS and how the change will ultimately benefit American health outcomes.